PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2010 2011 2012 2013 2014 2015
Goals and Objectives
Strengthen referral and consultation services for HIV/AIDS and TB/HIV care
- Provide HIV/AIDS and TB/HIV technical support at Princess Marina Hospital (PMH) and Nyangabgwe Referral Hospital (NRH) and increase technical and consultative support of Sekgoma Memorial Hospital (SMH) and Mahalapye General Hospital (MHG).
- Enlist non-pediatricians to care for stable patients
- Increase the time that the Center of Excellence (COE) HIV specialists mentor
- Improve referral linkages with clinics and other healthcare centers to allow referrals of stable clients to peripheral sites, while building capacity at those sites.
- Expand adolescents services and training at the COE and supported sites
- Strengthen relationships with civil-society organizations and community-level strategies that benefit HIV-infected children and adolescents
- Strengthen services in pediatric TB prevention, diagnosis and treatment at referral centers in Gaborone, Francistown, and Serowe.
- Build capacity in TB-care through training and mentorship at COE-supported referral centers
- Begin transition of project to Masa and Botswana National Tuberculosis Program within 5 years.
Build the sustainability and impact of Botswana's supportive onsite, case-based mentorship
- Continue coverage of current mentorship sites, incorporating Master Trainer strategies, and expanding sites in the Francistown and Serowe regions
- Coordinate clinical attachments at the COE with the goal of every specialist-patient encounter being a mentorship opportunity
- Assist in all pediatric components of the ARV Nurse Prescriber Training Program, develop a plan for task-shifting to train nurse prescribers, and implement that plan
- Begin transition of mentorship program to University of Botswana (UB) in the upcoming five years.
Eliminate gaps in didactic training on pediatric HIV/AIDS and TB/HIV care
- Revise and update Pediatric KITSO (KITSO HIV/AIDS Training Coordinating Unit) curricula annually.
- Deliver Pediatric KITCU to all of Botswana's health districts annually, working with the Ministry of Health (MOH) and the Minis try of Local Government (MLG) to maximize coverage among those caring for HIV-infected children.
- Distribute standard Pediatric ART reference tools during Pediatric KITCU trainings
- Develop new easy-reference clinical tools to encourage guidelines-based HIV care
- Institute routine post-Pediatric KITCU follow-up, assessing knowledge retention and application of key clinical practices
- Develop pre-service assistance strategies for UB and Institute for Health Sciences, and implement desired curricula
- Begin transition of training activities to UB within five years.
Develop and support a program in adolescent HIV/AIDS care.
- Develop and deliver an "Adolescent Care Package"
- Incorporate new modules on adolescent treatment and care into Pediatric KITCU training.
- Develop and publish Guidelines on the Care and Treatment of HIV-Positive Adolescents.
- Roll-out the COE "Teen Club" program nationally
- Develop and implement an adolescent-focused community partners training program
- Begin transition of adolescent-focused activities to UB and Masa within 5 years.
Target populations
HIV and TB-infected and affected children, families and communities
Geographic coverage
Botswana
Cross-Cutting Areas
Human resources for health, Food and nutrition/commodities
Education, Reducing violence and coercion.
The BBCCCOE program involves the following:
- Child survival activities
- Gender equity in HIV
- Male norms and behaviors
The BBCCCOE will become more cost efficient, particularly in coordinating service-delivery with other partners, including the MOH, MLG and Masa, in building sustainable capacity through assisting local skills acquisition, including specialist support of Botswana's pediatric HIV referral centers; Pediatric KITCU; task shifting through nurse prescriber mentoring and training and development of expert patient curricula; decentralized site mentorship designed to build sustainable capacity throughout the country; TB enhanced diagnosis; and adolescent care and support.
Partnership with the Princess Marina and Nyangabgwe Referral hospitals and the University of Botswana School of Medicine will expand.
Baylor will obtain the master trainer methodology (adult-focused) from the MOH and partners, and will work with the MOH and partners in its adaptation to a pediatric focus.
Baylor will work with local partners involved in pediatric training to ensure a smooth, non-overlapping implementation of pediatric master-trainer activities throughout Botswana.
Enhancing Sustainability
BCCOE will transition pediatric HIV/AIDS care and treatment to the Government of Botswana in a manner that ensures sustained care of a reference standard.
We will assist in capacitating the MOH, such that the MOH will be able to take the lead nationally in pediatric HIV/AIDS care and treatment.
Monitoring and Evaluation
The BBCCCOE has a detailed Monitoring and Evaluation plan for Center activities, including those under this RFA, and makes regular reports to BOTUSA and other stakeholders. The BBCCCOE's complete M&E document is available for review upon request.
10.C.PC08: Baylor - Pediatric Care and Outreach Support - 230,000.00
We will continue strengthening referral and consultation services for HIV/AIDS and TB/HIV care with a careful focus on appropriate decentralization and capacity building. Activities will include continued support to PMH, NRH, SMH (Serowe) and Maun GH, triaging of stable clients to qualified non-pediatricians, maximizing mentorship hours of experienced providers at the COE and other supported sites, minimizing the number of HIV specialists consulting clients in the absence of a learner, improving linkages with clinics and other healthcare centers nationwide along with the allocation of limited specialist resources to complex care and building technical capacity, expanding services and training to improve support of older children and adolescents, providing decentralized HIV support services to community-based NGOs, and strengthening community-based care. Baylor will further strengthen pediatric HIV/AIDS and TB/HIV care by continuing to build the sustainability and positive impact of supportive on-site, case-based mentorship through the Pediatric Master Trainer strategy, clinical attachments of HCWs to the COE, and appropriate task shifting, including Baylor's leading role in the roll out of the ARV Nurse Prescriber Training Program.
In cooperation with the various partners (MOH, MLG, BHP, and other KITSO partners), Baylor staff will work toward the elimination of coverage gaps in up-to-date, in-service, didactic training on pediatric HIV/AIDS and TB/HIV care and strengthen pre-service training delivery. This will include the development and deployment of a Pediatric Master Trainer Model, and the revising and delivering of pediatric KITSO curricula to all of Botswana's health districts annually. Teacher training in Setswana will continue to expand, as will routine post-training follow-up, including linkages with the COE Clinical Mentorship Team for site-specific follow-up and performance assessment in relation to key teaching points. Baylor staff will continue to work closely with the MOE, IHS, the UB School of Nursing, and the UB School of Medicine to develop, revise and implement desired pediatric HIV pre-service curricula. In the critical area of adolescent care, the COE, in collaboration with the MOH, drafted an "Adolescent Care Package," the finalization and implementation of which will be pursued in FY10.
10.T.PT08: Baylor - Pediatric ART treatment - 200,000.00
Baylor is aiming to strengthen the referral and consultation services for HIV/AIDS and TB/HIV care, with a focus on appropriate decentralization and capacity building by: · Triaging stable clients to qualified non-pediatricians, including trained medical officers and certified nurse prescribers, as appropriate. · Maximizing the mentorship hours of experienced providers at the COE and other supported sites and minimizing the number of HIV specialists consulting clients in the absence of a learner. · Improving linkages with clinics and other health care centers nationwide to allow for appropriate referrals to and from peripheral sites. · Continuing to cover the currently mentored sites, with the step-wise implementation of our newly-designed Pediatric Master Trainers strategy. · Continuing clinical attachments at the COE with the goal of every patient encounter being a learning opportunity for Botswana health care workers, including task-shifting, which plays a leading role in the roll out of the ARV Nurse Prescriber Training Program. · In cooperation with the MOH, MLG, and other KITSO partners, revising and delivering Pediatric KITSO curricula and a Pediatric Master Trainer Model to all of Botswana's health districts annually. · Instituting routine post-training follow-up, including linkages with the COE Clinical Mentorship Team for site-specific follow up and performance assessments in relation to key teaching points. · Continuing to work closely with the MOE, IHS, the UB School of Nursing, and the UB School of Medicine to develop, revise and implement desired pediatric HIV pre-service curricula. Additionally, Baylor plans to develop and support the implementation of a program in adolescent HIV/AIDS care and treatment by: · Developing national guidelines on the care and treatment of HIV-positive adolescents to guide providers in adolescent care, and developing and implementing a comprehensive training and mentoring program, including new adolescent modules within the pediatric KITSO training program.
10.C.TB14: Baylor Pediatric HIV/TB mangemnt - 107,500.00
The diagnosis of tuberculosis in children has always been a challenge. To improve the management of children with TB and TB/HIV co-infections, the BHP will collaborate with the National TB Program (and other stakeholders) to: a. review and refine the existing screening algorithm for TB diagnosis in children, and review and provide current information, education and communication materials for adolescents and parents of children with TB/HIV co-infection. b. provide training for health care workers on routine HIV testing (RHT) services for children presenting with TB in all facilities through awareness training to facilitate early identification of HIV co-infections. c. provide training of health care workers on pediatric TB case management. d. undertake joint support supervisory visits for M & E. e. improve logistical support. f. decentralize pediatric training and care efforts, which have been concentrated mainly in hospitals, through the BHP Master Trainer Team who are currently involved in the expansion and devolving of pediatric training and support to peripheral facilities. g. facilitate training of laboratory personnel on TB microscopy at peripheral labs. h. integrate pediatric TB care with community support mechanisms.
